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Returning to work after a mental health crisis

How to return to work after a mental health crisis.

Mental illness increases the risk of unemployment and early retirement. It is therefore important that people recovering from a mental health crisis are offered support with returning to work. BAuA is currently conducting research into the RTW process in a number of projects.

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In Germany, mental illness has for many years been one of the conditions with the longest average period of absence from work. While case numbers have risen marginally and since 2011 have stabilised at a high level, the duration of sick leave has increased steadily. This leads to high direct costs in the healthcare sector and high indirect costs to the economy due to losses in production and labour productivity.

Mental health and disorders in the world of work

Health promotion is an important resource for the mental health and workability of employees. Mental health is not just physical, mental and social well-being, but also the competence to cope with challenges, problems and crises constructively. In addition, it is not just the absence of disease, but rather a dynamic relationship between being healthy and being sick. Mental health and disorders are therefore two states that are dependent on one another.
In this sense, successful processing or coping with a mental crisis and an effective return to work is also an expression on mental health.

Overview of recent publications

  • Over the last few years, BAuA completed the project bundle “Mental disorders in the workplace”, which included four sub-projects:
  • A scoping review on RTW determinants
  • A mixed methods follow-up study on determinants for a successful return to work
  • A study on psychosomatic consultations in the workplace
  • A study on linking clinical and occupational players in the RTW process

The results of the studies formed the basis of the latest publications. In particular, these included a best practice guide on returning to work after a mental health crisis; detailed factsheets on operational integration management (OIM), gradual return to work (G RTW), RTW interviews, self-efficacy and psychosomatic consultations; a research report on a qualitative sub-study of the mixed methods follow-up study; and several peer-reviewed papers on RTW. For direct access please refer to our German Website.

Key aspects of returning to work after a mental health crisis

One of the major challenges in returning to work after a mental health crisis is the fear of stigmatization. Stigmatization or the fear thereof affects

  • self-confidence,
  • target orientation,
  • social interaction, and consequently
  • the work ability of returning employees.

In addition to anxiety and self-consciousness, stigmatization also creates conflicts at work and hinders productivity. This makes early treatment and the return to work more difficult.
It is important that the issue of mental health is dealt with openly and that it can be handled appropriately in the workplace. Relevant training for managers, and education and awareness initiatives for colleagues are particularly helpful here.

Which factors can affect the return to work?

Alongside interpersonal conditions, there are many other factors that can affect the RTW process after mental illness in different ways:

  • the severity and, above all, the duration of the illness,
  • the subjective RTW prognosis,
  • the complexity of mental health crises
  • the self-management of returning employees,
  • the collaboration between treating physicians, therapists, returning employees and key players in the workplace,
  • the professional support for returning employees,
  • the social support from supervisors and colleagues,
  • the gradual return to work as a therapeutic measure, and
  • other preventative and health-promoting measures.

Interconnected individual and work-related measures are particularly significant here. They include measures that support the self-management of returning employees through feedback and coaching sessions with supervisors and RTW experts (RTW coaches, disability managers) as well as work design measures that protect returning employees from persistent excessive demands and create space for new coping strategies. The aim is to provide health-promoting procedures and boost the long-term success of the return to work. A personal risk assessment and a gradual return to work (G-RTW) are central to the arrangements for the return and the implementation of relevant measures.

The therapeutic orientation of the G-RTW offers scope to achieve an optimal balance between individual, social and operational conditions: in direct self-reflection, in the team and working conditions.

Improved integration of prevention, early detection and return to work: current BAuA research projects

One of BAuA’s key objectives is to gain a better understanding of prevention and RTW measures over the coming years and test and investigate new approaches that could be applied to the healthcare system at the interface between medical/therapeutic treatment and occupational prevention. BAuA is currently involved in two third party-funded research projects:

  • RTW-PIA – Intensified return to Work (RTW) aftercare in psychiatric outpatient clinics of psychiatric hospitals
  • friaa - Early intervention in the workplace – a service for companies and their employees

The aim of these projects is to improve care for people with mental health issues or disorders through better cooperation between clinics, therapists and key players in the workplace, such as company physicians, OIM officers and supervisors.

For further detailed information please refer to our German Website.

Research Projects

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